Curing cancer

Cancers are difficult to treat. They are caused by rogue cells that exhibit destructive behaviour inside the body and if not checked can – and do – kill the body that hosts them. Radio and chemotherapy sometimes alleviate the symptoms but for all our skill and advancement in the medical sciences we have yet to find a cure for cancer. We can operate on it, cut it out, or create a therapeutic environment in which it goes into remission but an actual cure eludes us. Curing the cancer described by President Obama as he detailed the new Af-Pak strategy is going to be extremely difficult. The difficulty lies in the fact that the disease is already widely disseminated and does not have a single locus. It is also not a single type of cancer, but several. Taking Al Qaeda first – it is a global entity not confined only to the region we live in, and it as much a set of loosely defined ideals rooted in an equally loosely defined idea of a global caliphate as it is a corporate body. It is not an organization which holds annual board meetings and presents its accounts to shareholders in any conventional sense. Neither is it an organization that is susceptible to traditional military intervention – ideas respond poorly to missile strikes. Identifying those parts of it which may be treated (or cut out) is not easy either – there is now an 'old' Al Qaeda and a 'young' – Osama bin Laden and Mullah Omar are increasingly yesterday's men, with Mehsud, Haqqani and Al Libi as the new generation; a reality acknowledged in the bounty-attached hit list issued by the US this week. Cutting out the primary tumours still leaves you with the secondaries. Turning now to the tangible – civilian aid – Obama has talked about there being 'no blank cheque' for Pakistan which implies a process of accountability. As every donor nation that has ever given a rupee to Pakistan has discovered, this is a vast black hole into which money may be poured for eons without having any discernible effect. It is corrupt at every level and those who stand to gain from the latest windfall of ready cash will already be devising ways in which it can be diverted to their personal use. This is an entirely different form of cancer, more akin to leukaemia than a localized tumour. This is the cancer in the blood of the nation that has never been susceptible to treatment and which has always debilitated us. We will be delighted to have your money Mr Obama but if it is going to do what you want it to do – strengthen civil institutions and parliamentary democracy - then it needs to come hedged about with the most stringent of safeguards. We are entering a period of transactional relationship with which the bureaucratic establishment is unlikely to be cooperative, particularly if oversight is part of the transaction.The third cancerous element that the Af-Pak strategy seeks to address is that of the polity of both nations. One is a narco-state nominally ruled by the mayor of Kabul and the other is a feudal autocracy with a cosmetic parliament attached for reasons of modesty. Neither is exactly healthy ground for the regeneration of civil institutions. As consolation, the Af-Pak strategy has moved on from the fruitless quest for the Holy Grail of democracy in Afghanistan and recognized it for what it is – eternally quarrelsome with itself and unimpressed with western democratic models that get in the way of time-honoured traditions such as the blood feud and wholesale brigandry. Pakistan does at least have some semblance of civil institutions that could, with a fair wind and the development of a new cadre of younger politicals not tied to the feudal tradition; begin to push back the cancer that currently eats away at it. Prime Minister Gilani has recently acknowledged the problems we face because successive governments had concentrated on combating external threats at the cost of ignoring the internal threat – the cancer – that was spreading meanwhile inside. President Obama has talked of one cancer where there are many. Everybody is agreed in recognizing the disease and its symptoms, but treatment is going to have to be multi-disciplinary and may require what doctors call 'heroic' surgery. In general terms we can but welcome the Obama plans. It really is a way of 'doing it differently', it really is the 'change' that he spoke of during his campaign for the worlds top job. For it to work we have to do it differently as well. Not something we have ever excelled at in the past. For Obama constant change is here to stay, whereas for us real change, the change that leads to growth and maturity, has always been avoided – a consequence of which may be a slow and painful death from cancer.